Lorberboym M, Mechanick J I
Department of Radiology, Mount Sinai School of Medicine, New York, New York 10029, USA.
J Nucl Med. 1996 Sep;37(9):1532-5.
A 67-yr-old woman who underwent total thyroidectomy 32 yr ago developed accelerated hyperthyroidism after injection of iodinated contrast media to evaluate a left hemipelvis mass. The patient was managed with propylthiouracil, beta-blockers and digoxin. Whole-body 201TI and 131I scans demonstrated a functioning metastasis in the left hemipelvis where biopsy revealed a well differentiated follicular thyroid carcinoma. Palliative external beam radiotherapy was administered. The patient then received radioiodine treatment with granulocyte colony-stimulating factor to minimize bone marrow toxicity. Clinically significant thyrotoxicosis occurring in metastatic thyroid carcinoma is rare and results from abnormal ectopic thyroidal tissue iodine metabolism. Iodide-containing medications and contrast media should be avoided in patients with functioning thyroid metastases to prevent abrupt increases in circulating thyroid hormone levels.
一名32年前接受全甲状腺切除术的67岁女性，在注射碘化造影剂以评估左半骨盆肿块后出现了加速性甲状腺功能亢进。患者接受了丙硫氧嘧啶、β受体阻滞剂和地高辛治疗。全身201铊和131碘扫描显示左半骨盆有一个功能性转移灶，活检显示为高分化滤泡状甲状腺癌。给予姑息性外照射放疗。然后患者接受了放射性碘治疗并使用了粒细胞集落刺激因子以尽量减少骨髓毒性。转移性甲状腺癌中发生具有临床意义的甲状腺毒症很罕见，是由异常的异位甲状腺组织碘代谢引起的。对于有功能性甲状腺转移的患者，应避免使用含碘药物和造影剂，以防止循环甲状腺激素水平突然升高。
